指端创面放血法在无静脉断指再植中的疗效观察及对术后肢体功能的影响-现代医学

指端创面放血法在无静脉断指再植中的疗效观察及对术后肢体功能的影响

单位：江苏省南通市第一人民医院骨科, 江苏南通 226001

分类号：R683.41

出版年·卷·期（页码）：2017·36·第八期（1080-1083）

摘要：

目的：探讨指端创面放血法在无静脉断指再植患者中的疗效观察及对术后肢体功能的影响。方法：选取我院2014年4月~2016年3月无静脉断指再植患者105例，并依据治疗方式的不同分为治疗组（n=52）和对照组（n=53）。治疗组给予指端创面放血法治疗，对照组给予甲床渗血法治疗。观察并比较2组临床疗效；检测并比较2组患者肢体情况。结果：治疗组换药次数、住院天数、再植指体水泡指数、伤口局部溃烂指数、再植体部分坏死指体均明显低于对照组（P<0.05或P<0.01），再植成活指数和成活率均显著高于对照组；治疗组的优良率为82.70%，显著高于对照组的64.15%，差异显著，具有统计学意义（P<0.05）；2组患者术后4个月患指外形均佳，指腹较饱满，血运畅，指体无明显萎缩，且指甲生长较为平整。其中治疗组指甲长度显著长于对照组，感觉等级、DIPJ活动度均显著高于对照组（P<0.05或P<0.01），2-PD距离明显低于对照组（P<0.01）。结论：指端创面放血法可明显提高无静脉断指再植患指的成活率，并能有效加快指甲的生长速度及感觉神经的恢复，同时能明显提高肢体活动度，值得临床推广应用。

Objective: To investigate the effect of fingertip wound phlebotomy in patients with reunion of distal severed fingers and its impact on postoperative limb function.Methods: 105 cases of distal severed fingers patients in our hospital were selected from April 2014 to March 2016, and according to the different treatment divided into treatment group(n=52)and control group(n=53). The treatment group was given fingertip wound phlebotomy treatment, while the control group was given nail bed oozing treatment. The clinical efficacy of the two groups were observed and compared; the movement of the two groups were detected and compared.Results: The numbers of dressing change, length of hospitalization, vacuole numbers on replanted fingers, local wound blisters fester numbers, necrosis of replanted fingers in the treatment group were significantly lower than those in the control group(P<0.05 or P<0.01), the survival numbers and survival rate were significantly higher than those in the control group(P<0.05); the excellent and good rate combined in the treatment group was 82.70%, which was significantly higher than that 64.15% in the control group, and the difference between the two groups was significant(P<0.05); 4 months after surgery, the shape of the fingers were good, the fingers were intact, blood was smooth, the fingers had no obvious atrophy, and nail growth was smooth. The nail length in the treatment group was significantly longer than that in the control group, the sensory grade and DIPJ activity were significantly higher than those in the control group(P<0.05 or P<0.01), and the 2-PD was obviously lower than that in the control group(P<0.01).Conclusion: Fingertip wound phlebotomy can significantly improve the survival rate of reunion of distal severed fingers, and effectively accelerate the growth speed of nail and sensory nerve recovery, significantly improve the physical activity, therefore it is worthy of clinical application.

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